Musculoskeletal System Overview

Ossification is the process by which the bone matrix (collagen fibers and ground substance) is formed and hardening minerals (eg, calcium salts) are deposited on the collagen fibers. The collagen fibers give tensile strength to the bone, and the calcium provides compressional strength. 206 total bones in Human Body Categories of Bones Long bones (eg, femur) Short bones (eg, metacarpals) Flat bones (eg, sternum) Irregular bones (eg, vertebrae)
osteoblast: bone-forming cell osteoclast: bone resorption cell osteocyte: mature bone cell

2. Angiogenesis and cartilage formation: Under the influence of signaling molecules, cell proliferation and differentiation occur. Blood vessels and cartilage overlie the fracture. 3. Cartilage calcification: Chondrocytes in the cartilage callus form matrix vesicles, which regulate calcification of the cartilage. Enzymes within these matrix vesicles prepare the cartilage for calcium release and deposit. 4. Cartilage removal: The calcified cartilage is invaded by blood vessels and becomes resorbed by chondroblasts and osteoclasts. It is replaced by woven bone similar to that of the growth plate. 5. Bone formation: Minerals continue to be deposited until the bone is firmly reunited. With major adult long bone fractures, ossification takes 3 to 4 months. 6. Remodeling: The final stage of fracture repair consists of remodeling the new bone into its former structural arrangement. Remodeling may take months to years, depending on the extent of bone modification needed, the function of the bone, and the functional stresses on the bone. Cancellous bone heals and remodels more rapidly than does compact cortical bone. Types of Fracture

Bone Healing
Fracture healing occurs in four areas, including: Bone marrow, where endothelial cells rapidly undergo transformation and become osteoblastic bone-forming cells Bone cortex, where new osteons are formed Periosteum, where a hard callus/bone is formed through intramembranousossification peripheral to the fracture, andwhere a cartilage model is formed through endochondral ossification adjacent to the fracture site External soft tissue, where a bridging callus (fibrous tissue) stabilizes the fracture 1. Hematoma and inflammation: The bodys response is similar to that after injury elsewhere in the body. There is bleeding into the injured tissue and formation of a fracture hematoma. The hematoma is the source of signaling molecules, such as cytokines, transforming growth factor-beta (TGF-), and platelet-derived growth factor (PDGF), which initiate the fracture healing processes. The fracture fragment ends become devitalized because of the interrupted blood supply. The injured area is invaded by macrophages (large white blood cells), which dbride the area. Inflammation, swelling, and pain are present. The inflammatory stage lasts several days and resolves with a decrease in pain and swelling.

Greenstick fracture: an incomplete fracture in which the bone is bent. This type occurs most often in children. Transverse fracture: a fracture at a right angle to the bone's axis. Oblique fracture: a fracture in which the break has a curved or sloped pattern. Comminuted fracture: a fracture in which the bone fragments into several pieces. An impacted fracture is one whose ends are driven into each other. This is commonly seen in arm fractures in children and is sometimes known as a buckle fracture. Other types of fracture are pathologic fracture, caused by a disease that weakens the bones, and stress fracture, a hairline crack. Other types of fracture are pathologic fracture, caused by a disease that weakens the bones, and stress fracture. Terminologies
brace: externally applied device to support body, control movement, and prevent injury cast: rigid external immobilizing device molded to contours of body part fracture: a break in the continuity of the bone splint: device designed specifically to support and immobilize body part in desired position traction: application of a pulling force to a part of the body